Physician–patient dialogue surrounding patients’ expression of concern: applying sequence analysis to RIAS

Eide, Hilde; Quera, Vicenç; Graugaard, Peter Kjær; Finset, Arnstein

doi:10.1016/j.socscimed.2003.10.011

Cited by 92 publications

(76 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We conducted qualitative, quantitative, and sequence analyses that revealed predictable sequences of physician response to patient expressions of worry. Consistent with prior work by Eide et al, 35 physicians' most common initial response was nonspecific acknowledgement; in addition, many physicians also asked biomedical questions and provided medical explanations and reassurance. Later, physicians tended to take action by suggesting a diagnostic test, medication, or other treatment.…”

Section: Discussionsupporting

confidence: 55%

“…Because SPs were scripted, we could not study antecedents to patient expressions of concern. 35 Finally, SP visits are, by definition, first visits, and therefore may not represent physician actions in established relationships. Strengths of the study include our use of 2 sources of data: patient surveys and unannounced SP encounters.…”

Section: Limitations and Strengthsmentioning

confidence: 99%

See 1 more Smart Citation

“Could this Be Something Serious?”

et al. 2007

View full text Add to dashboard Cite

BACKGROUND: Previous work suggests that exploration and validation of patients' concerns is associated with greater patient trust, lower health care costs, improved counseling, and more guideline-concordant care. OBJECTIVE:To describe physicians' responses to patients' worries, how their responses varied according to clinical context (straightforward versus medically unexplained symptoms [MUS]) and associations between their responses and patients' ratings of interpersonal aspects of care.DESIGN: Multimethod study. For each physician, we surveyed 50 current patients and covertly audiorecorded 2 unannounced standardized patient (SP) visits. SPs expressed worry about "something serious" in 2 scenarios: straightforward gastroesophageal reflux or poorly characterized chest pain with MUS. PARTICIPANTS:One hundred primary care physicians and 4,746 patients. MEASUREMENTS:Patient surveys measuring interpersonal aspects of care (trust, physician knowledge of the patient, satisfaction, and patient activation). Qualitative coding of 189 transcripts followed by descriptive, multivariate, and lag-sequential analyses. RESULTS:Physicians offered a mean of 3.1 responses to each of 613 SP prompts. Biomedical inquiry and explanations, action, nonspecific acknowledgment, and reassurance were common, whereas empathy, expressions of uncertainty, and exploration of psychosocial factors and emotions were uncommon. Empathy expressed during SP visits was associated with higher patient ratings of interpersonal aspects of care. After adjusting for demographics and comorbidities, the association was only statistically significant for the MUS role. Empathy was most likely to occur if expressed at the beginning of the conversational sequence.CONCLUSIONS: Empathy is associated with higher patient ratings of interpersonal care, especially when expressed in situations involving ambiguity. Empathy should be expressed early after patient expressions of worry.

show abstract

Section: Discussionsupporting

confidence: 55%

Section: Limitations and Strengthsmentioning

confidence: 99%

“Could this Be Something Serious?”

et al. 2007

View full text Add to dashboard Cite

show abstract

“…There is increasing interest in sequential analysis and capturing reciprocity within large health communication coded data sets. [49][50][51][52][53] 266 ELLINGTON ET AL.…”

Section: Rias Application To Hospice Encountersmentioning

confidence: 99%

Hospice Nurse Communication with Patients with Cancer and their Family Caregivers

Ellington

Reblin

Clayton

et al. 2012

Journal of Palliative Medicine

View full text Add to dashboard Cite

Background: Effective communication by hospice nurses enhances symptom management for the patient, reduces family caregiver burden and distress, and potentially improves bereavement adjustment. However, research has not kept pace with the rising use of hospice by patients with cancer and thus we know little about how hospice nurses communicate. Methods: The overriding objective of this pilot study was to provide insight into these in-home visits. Hospice nurses audiorecorded their interactions over time with family caregivers and patients with cancer. The communication within these tapes was coded using Roter Interaction Analysis System (RIAS) and analyzed. Results: We found that tape recording home hospice nurse visits was feasible. RIAS was suited to capture the general content and process of the home hospice encounter and the coded interactions show the range of topics and emotions that are evident in the dialogue. Implications and future directions for research are discussed.

show abstract

“…anxious patients, do not express this need explicitly by mentioning their concerns, but implicitly through the expression of cues. A core skill for nurses is therefore to recognize cues of patients that are clinically relevant but not directly expressed [6]. Picking up cues of patients may lead to the recognition of patients who need emotional support.…”

Section: Introductionmentioning

confidence: 99%

Nurse–patient communication in cancer care: does responding to patient's cues predict patient satisfaction with communication

Uitterhoeve

Bensing

Dilven³

et al. 2009

Psycho-Oncology

View full text Add to dashboard Cite

Objective: The aim is to investigate the relationship between nurses' cue-responding behaviour and patient satisfaction.Methods: One hundred patient-nurse conversations about present concerns were videotaped and patients' expression of emotional cues and nurses' cue responses were coded using the Medical Interview Aural Rating Scale. Nurses (N 5 34) and patients (N 5 100) were recruited from seven oncology inpatient clinics from a University Medical Centre.Results: A mixed-model analysis was conducted to examine whether cue responding was related with patient satisfaction with the conversation, after adjusting for confounding variables and correlation due to repeated measure of each nurse. Nurses' cue responding was independently related to patient satisfaction. Controlling for the level of cue responding, palliatively treated patients were more satisfied with the communication than curatively treated patients.Conclusions: This study provides evidence that nurses' cue-responding behaviour is appreciated by the patients. Future studies might focus on the effect of improved cueresponding skill on more distal outcome measures, such as identification of concerns, mood and coping behaviour.

show abstract

Physician–patient dialogue surrounding patients’ expression of concern: applying sequence analysis to RIAS

Cited by 92 publications

References 26 publications

“Could this Be Something Serious?”

“Could this Be Something Serious?”

Hospice Nurse Communication with Patients with Cancer and their Family Caregivers

Nurse–patient communication in cancer care: does responding to patient's cues predict patient satisfaction with communication

Contact Info

Product

Resources

About